Trauma care (Basel, Switzerland)最新文献

{"title":"A Systematic Literature Review of the Contribution Accumulation Makes to Psychological and Physical Trauma Sustained through Childhood Maltreatment","authors":"I. Bryce, Simone Collier","doi":"10.3390/traumacare2020026","DOIUrl":"https://doi.org/10.3390/traumacare2020026","url":null,"abstract":"The pervasive effects of cumulative harm resulting from adverse childhood experiences influence all aspects of an individual’s life course. Research highlights a relationship between accumulation and trauma symptomology across all domains of harm and risk. A systematic literature review was conducted to explore and synthesize the current evidence base for the contribution accumulation makes to psychological and physical injury of childhood trauma. A search was conducted relevant to two areas of interest: (a) “cumulative harm” or “cumulative trauma” and (b) “consequences and outcomes”. Database searches and further manual searches yielded a total of 1199 articles, and 12 studies satisfied all the inclusion criteria. Only studies that were peer-reviewed and published between January 2011 and January 2022 were included. The evidence from the review indicated that multiplicity and polyvictimization, parental history and intergenerational transmission of trauma, systemic cumulative harm, and developmental lifespan outcomes were associated with the likelihood and impact of the accumulation of physical and psychological injury. The findings of this review contribute valuable knowledge to allow for a better understanding of the physical and psychological impact of accumulated and chronic childhood trauma. This knowledge will improve intervention, prevention, and management strategies for helping professionals working with traumatized or vulnerable children and adults.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43858587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Don't Do Anything; I'm Just Being Taken Care Of\": Experiences of Patients and Their Caregivers Transitioning Back into the Community Following Traumatic Injury in Northern Tanzania.","authors":"Anna Tupetz, Loren K Barcenas, Julia E Isaacson, Joao Ricardo Nickenig Vissoci, Victoria Gerald, Julius Raymond Kingazi, Irene Mushi, Timothy Antipas Peter, Catherine A Staton, Blandina T Mmbaga, Janet Prvu Bettger","doi":"10.3390/traumacare2020028","DOIUrl":"10.3390/traumacare2020028","url":null,"abstract":"<p><p>After discharge from the hospital for traumatic injury, patients and their caregivers face a period of increased vulnerability. This adjustment phase is poorly characterized, especially in low- and middle-income countries. We explored the experiences of patients and their caregivers in Northern Tanzania after hospitalization for a traumatic injury. Patients who received care for traumatic injury at the Kilimanjaro Christian Medical Center and their caregivers were selected as part of a convenience sample from January 2019 to December 2019. Analysts developed a codebook; content and analytic memos were subsequently created. We then applied the biopsychosocial model to further characterize our findings. Participants included 26 patients and 11 caregivers. Patients were mostly middle-aged (mean age 37.7) males (80.8%), residing in urban settings (57.7%), injured in road traffic accidents (65.4%), and who required surgery (69.2%). Most caregivers were female. Seven major themes arose: pain, decreased physical functioning, poor emotional health, lack of support, challenges with daily activities, financial strain, and obstacles to accessing healthcare. This study describes some of the difficulties transitioning back into the community after hospitalization for traumatic injury. Our work demonstrates the importance of mixed methods approaches in characterizing and addressing transitions of care challenges.</p>","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":"2 2","pages":"341-358"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10238087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avoiding Allostatic Load: Black Male Collegians and the Quest for Well-Being","authors":"V. Livingston, Breshell Jackson-Nevels, Quincy Dinnerson","doi":"10.3390/traumacare2020025","DOIUrl":"https://doi.org/10.3390/traumacare2020025","url":null,"abstract":"The literature suggests that African American/Black males are less likely to seek professional assistance for mental health and other personal concerns than African American/Black females and that they are more likely to seek informal help for mental health problems than professional help. Are there circumstances where African American/Black males would seek professional help over informal help? This research updates what is currently known about African American/Black male collegians’ help-seeking behaviors and the circumstances or conditions that might influence professional help-seeking. Secondary data illustrating the help-seeking behaviors of African American/Black male collegians at an urban HBCU was examined to identify patterns or trends during the first semester of 2018 and 2019. De-identified data sheets for 103 African American/Black males were examined to identify referral sources, current mental health concerns, and past mental health concerns. African American/Black male and female collegians sought professional assistance for similar concerns: family problems, couples problems, peer interpersonal problems, depression, anxiety, and stress. Black males were more likely to self-refer for professional assistance than seek informal assistance. Implications for university counseling centers are explored.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47547699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Predictors of Generalized Anxiety Disorder Symptoms in Residents of Fort McMurray Five Years after the Devastating Wildfires","authors":"E. Owusu, R. Shalaby, E. Eboreime, N. Nkire, B. Agyapong, G. Obuobi-Donkor, M. Adu, W. Mao, F. Oluwasina, Mobolaji A Lawal, V. Agyapong","doi":"10.3390/traumacare2020024","DOIUrl":"https://doi.org/10.3390/traumacare2020024","url":null,"abstract":"Background: Natural disasters adversely impact individuals living in places where they occur, resulting in emotional distress. The wildfire that occurred in Fort McMurray (FMM), Alberta in 2016 is no different. Objective: This study aims to identify the prevalence and predictors of Generalized Anxiety Disorder (GAD) symptoms in residents of FMM five years after the devastating wildfires. Methods: Data for the study were collected through a cross-sectional survey conducted online from the 24th of April to the 2nd of June 2021. A validated instrument, the GAD-7 scale, was used to collect information on anxiety. Results: This study involved 186 residents of FMM, of which the majority were females (85.5%), employed (94.1%), working at school boards (50.0%), and were either married, cohabiting, or partnered (71.0%). The prevalence of likely GAD among the study sample was 42.5%. Unemployed respondents were seventeen times more likely to develop GAD symptoms (OR = 16.62; 95% C.I. 1.23–223.67) while respondents who would like to receive mental health counseling were five times more likely to experience GAD symptoms (OR = 5.35; 95% C.I. 2.03–14.15). Respondents who suffered a loss of property because of the wildfire were two times more likely to develop GAD symptoms (OR = 2.36; 95% C.I. 1.01–22.62). Conclusion: Policymakers may mitigate GAD symptoms, particularly after natural disasters, by making long-term mental health counseling available and a key component of post-disaster management, and by investing in the social capital of the people to build resilience and support to deal with the post-disaster mental health effects.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49257705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of the Shock Index for Predicting Survival, Function and Health Status Outcomes in Major Trauma Patients: A Registry-Based Cohort Study","authors":"Lena Wikström, T. Kander, B. Gabbe","doi":"10.3390/traumacare2020023","DOIUrl":"https://doi.org/10.3390/traumacare2020023","url":null,"abstract":"The shock index (SI; heart rate/systolic blood pressure) has been found to predict mortality in trauma patients. The aims of this study were to establish whether the SI improved the prediction of an existing model for both mortality and longer-term outcomes in major trauma patients. In total, 29,574 adult (>15 years) major trauma patients were included from the Victorian State Trauma Registry with a date of injury from July 2009 to June 2019. Outcomes of interest were survival to hospital discharge and function and health status at 6 months post-injury. Survival and function were analysed using measures of discrimination and calibration, whereas health status was assessed with R2 and MRSE measures. The area under the receiver operating characteristic curve (AUC) of the VSTR survival model improved when the SI was added (AUC 0.797 (0.787–0.807) versus AUC 0.807 (0.797–0.816), p < 0.001). For the prediction of functional outcome 6 months post-injury, the inclusion of the SI increased the AUC marginally (AUC 0.795 (0.786–0.803) versus AUC 0.799 (0.791–0.807), p < 0.001). When predicting in-hospital mortality and health status 6 months post-injury, including the SI resulted in a slightly better fit to the registry-risk adjustment model. In the future, external validation and the exploration of other models to improve prediction outcomes are warranted.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47323694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Australian Approach to Managing Traumatic Abdominal Wall Hernias","authors":"A. Liesegang, Skyle Murphy, J. Theodore, Peita M. Webb, H. Sethi, David S. R. Lockwood","doi":"10.3390/traumacare2020022","DOIUrl":"https://doi.org/10.3390/traumacare2020022","url":null,"abstract":"Traumatic abdominal wall hernias (TAWH) occur in less than one percent of trauma presentations. In the absence of clinical guidelines, management is centre-specific and largely dependent on surgeon experience. This study describes the management of TAWH in a high volume Australian trauma centre. A single centre retrospective cohort study was performed. Adults with TAWH as a result of blunt trauma, between January 2016 and July 2020, were included. Primary outcomes were the mechanism of injury, presentation, timing of repair, and operative technique used. A total of 16 patients (63% male; median age 36 years; median Injury Severity Score [ISS] 19.5) were identified. In total, 75% were the result of a motor vehicle accident. A total of 13 patients (81%) underwent repair. Eight patients received repair during emergency exploration undertaken for concurrent injuries. Three patients had a delayed repair during index admission, and two patients had an elective repair. Primary tissue repair was performed in seven patients. Mesh repair was used in six. Patients were followed for a median of 55.5 days. One patient had a recurrence of hernia following primary repair. This local series demonstrates that traumatic abdominal wall hernias may be successfully repaired during index admission using tissue or mesh techniques.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48623928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penetrating Cardiac Injuries: Outcome of Treatment from a Level 1 Trauma Centre in South Africa","authors":"S. Makhadi, M. Moeng, C. Ede, Farhana Jassat, Sechaba T Palweni","doi":"10.3390/traumacare2020021","DOIUrl":"https://doi.org/10.3390/traumacare2020021","url":null,"abstract":"Background: Penetrating cardiac injuries are rare in South African and international literature. Penetrating cardiac injuries are regarded as one of the most lethal injuries in trauma patients. The mechanism of injury varies across the world. In developing countries, stab wounds cause the majority of penetrating cardiac injuries. These injuries remain clinically challenging and are associated with high mortalities. Aim: To describe our experience with penetrating cardiac injuries and the outcome of their management at a level 1 trauma unit in Johannesburg, South Africa. Materials and methods: We retrospectively reviewed all patients who presented with penetrating cardiac injuries over a period of four years (1 January 2016 to 31 December 2019). The patients were identified using the hospital database. The patient’s demographics, mechanism of injury, injury severity score, vital signs, investigation findings, final diagnosis, type of operation, length of hospital stay, morbidities, and mortalities were recorded. Results: There was a total of 167 patients with penetrating cardiac injuries identified. There were 151 (90.4%) males, with an overall median age of 29 years (IQR 24–34). Stab wounds accounted for 77.8% of the injuries, while gunshot wounds (GSW) accounted for 22.2%. The median injury severity score (ISS) and revised trauma score (RTS) were 25 and 7.1, respectively. The right ventricle was the most injured chamber (34.7%), followed by the left ventricle (29.3%), right auricle (13.2%), right atrium (10.2%), and combined injuries accounted for 7% of injuries. A commonly used incision was a sternotomy (51.5%), left anterior-lateral thoracotomy (26.9%), emergency room thoracotomy (19.2%), and clamshell thoracotomy (2.4%). The overall mortality rate was 40.7%, with a 29.2% mortality in the stab wounds. Twenty-four (14.4%) patients died in the emergency department, sixteen (9.6%) patients died on the table in theatre, and the remaining twenty-eight (16.7%) died in the intensive care unit or wards. Gunshot wounds, other associated injuries, right ventricle injuries, a high ISS, low RTS, and low Glasgow coma scale were all significantly more likely to result in death (p < 0.001). Conclusions: Penetrating cardiac injuries are often fatal, but the mortality can be improved with appropriate resuscitation and a work-up. The injuries to the heart can be safely managed by trauma/general surgeons in our setting. The physiology in presentation and other associated injuries determines outcomes in patients with penetrating cardiac injury.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46034994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Groin Pain in Male High School Soccer Players Undergoing an Injury Prevention Program: A Cluster Randomized Controlled Trial","authors":"Kazuki Fujisaki, Kiyokazu Akasaka, Takahiro Otsudo, Hiroshi Hattori, Y. Hasebe, T. Hall","doi":"10.3390/traumacare2020020","DOIUrl":"https://doi.org/10.3390/traumacare2020020","url":null,"abstract":"Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45974120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Prehospital Spinal Immobilization in Patients with Penetrating Spinal Injuries: A Systematic Review and Meta-Analysis","authors":"Ibrahim G Alghamdi, Naif Bazaie, N. Alqurashi, Z. Ahmed","doi":"10.3390/traumacare2020019","DOIUrl":"https://doi.org/10.3390/traumacare2020019","url":null,"abstract":"Penetrating injuries, such as gunshot or stab wounds, may cause spinal cord injuries and require prehospital spinal immobilization (PHSI) to stabilize the spine. However, the use of PHSI in penetrating spinal injuries remains controversial. This systematic review aimed to investigate the efficacy of prehospital PHSI in patients with penetrating trauma. We systematically searched Google Scholar, Medline (PubMed), The Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE between January 2000 and July 2021. All studies in English that assessed PHSI in patients (>16 years) with penetrating spinal injuries were included. Quality and risk of bias assessments were performed using the modified Newcastle-Ottawa scale. A narrative synthesis and a meta-analysis was conducted. Our search identified 928 studies but only 6 met our inclusion and exclusion criteria. All of the included studies were conducted in the US and the number of patients ranged from 156–75,567 over 3–9 study years. The majority of patients were gunshot or stab wounds. Three studies demonstrated an increased risk of mortality with spinal collars whilst the remaining three studies failed to show any benefits or the benefits remained unproven. All studies were retrospective studies with some risks of bias. This review highlights that the evidence from the literature on PHSI in penetrating trauma outweigh its benefits; thus, its use is discouraged in penetrating spinal trauma. However, further high-quality research is necessary to reach definitive conclusions and to possibly identify suitable alternatives to PHSI for penetrating spinal trauma.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47989172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Reconstruction Following Self-Inflicted Gunshot Wounds: Predictors, Complications, and Acceptable Outcomes","authors":"Patrick A. Palines, Sarah Y. Park, Rory J. Loo, Jason R. Siebert, B. Grunert, S. Pawar, J. LoGiudice, R. Havlik, P. Hettinger","doi":"10.3390/traumacare2020018","DOIUrl":"https://doi.org/10.3390/traumacare2020018","url":null,"abstract":"Background: Self-inflicted gunshot wounds (SIGSWs) produce devastating facial defects that are challenging to reconstruct, but are rarely reported in large cohorts in the literature. This study sought to characterize these injuries, and identify parameters influencing complications and outcomes among survivors following facial reconstruction. Methods: A retrospective cohort study was performed identifying 22 patients with SIGSWs to the face reconstructed at our center from 2009 to 2019. Charts were reviewed for patient, injury, and reconstructive details and course. Outcomes were statistically compared to various parameters. Results: The most common firearm, orientation, and injured structure were the handgun (40.9%), submental (59.1%), and mandible (68.2%), respectively. Patients averaged a 21.7-day length of stay (LOS), 17.4 h to debridement, 2.6 days to bony fixation, 5.4 reconstructive surgeries, and 7 (31.8%) patients received at least one free flap. Fifteen (68.2%) patients had at least one major complication, although functional outcomes were ultimately relatively good overall. Notable outcome associations included submental orientation with a longer LOS (p = 0.027), external fixation with a longer LOS (p = 0.014), financial stressors with a shorter LOS (p = 0.031), and severe soft tissue injury with an increased total number of reconstructive surgeries (p = 0.039) and incomplete reconstruction (p = 0.031). There were no cases of suicidal recidivism. Conclusions: Reconstruction following facial SIGSW is challenging for both patient and surgeon, and carries a high rate of complications. However, patients can regain substantial function following reconstruction and the achievement of satisfactory outcomes.","PeriodicalId":75251,"journal":{"name":"Trauma care (Basel, Switzerland)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46960946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}